Bupropion for smokers
Authors: C. Harrison
Journal: BMJ (2001)

# Bupropion may not be as good as editorial implies {#article-title-2} EDITOR—Britton and Jarvis give a surprisingly uncritical welcome to bupropion.1 Although Jorenby et al did find that 30% of patients who took bupropion were still non-smokers after 12 months (point prevalence data), these volunteers must have been highly motivated as 12-15% of those who took the placebo successfully stopped smoking.2 There are no studies showing that bupropion is effective in more averagely motivated patients. The patients in Jorenby et al's study received intensive counselling, which comprised more than three hours of face to face counselling and 80 minutes of telephone support over the 12 months. It is not realistic for the NHS to provide this level of support. The manufacturers are offering a telephone line for patients to ring for support, but this is not likely to be as effective in motivating and supporting patients. The high success rates reported by Jorenby et al are therefore unlikely to be repeated in day to day practice. Britton and Jarvis could have pointed out that half of patients who successfully stop smoking with the aid of bupropion will start again within 12 months of coming off the drug. They could also have referred in more detail to the side effect profile and the number of patients for whom the drug will be unsuitable. Bupropion may have a 1 in 1000 risk of inducing seizures (product information from GlaxoWellcome, the manufacturer of the drug). This may be an acceptable risk for drugs to treat disease but is less so for lifestyle drugs. Bupropion may well prove to be a useful adjunct to smoking cessation, but I would have preferred a more balanced appraisal in a BMJ editorial. 1. 1.↵1. Britton J, 2. Jarvis MJ .Bupropion: a new treatment for smokersBMJ2000; 321:65–66. (8 July.) [OpenUrl][1][FREE Full Text][2] 2. 2.↵1. Jorenby DE, 2. Leischow SJ, 3. Nides MA, 4. Rennard SI, 5. Johnston JA, 6. Hughes AR, 7. et al .A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation.N Engl J Med1999; 340:685–691. [OpenUrl][3][CrossRef][4][PubMed][5][Web of Science][6] # Drug is almost identical in structure to diethylpropion, a controlled drug {#article-title-5} EDITOR—Britton and Jarvis's editorial on bupropion does not mention that the drug is an amphetamine derivative.1 It is almost … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DBritton%26rft.auinit1%253DJ.%26rft.volume%253D321%26rft.issue%253D7253%26rft.spage%253D65%26rft.epage%253D66%26rft.atitle%253DBupropion%253A%2Ba%2Bnew%2Btreatment%2Bfor%2Bsmokers%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.321.7253.65%26rft_id%253Dinfo%253Apmid%252F10884238%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=bmj&resid=321/7253/65&atom=%2Fbmj%2F322%2F7283%2F431.atom [3]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DJorenby%26rft.auinit1%253DD.%2BE.%26rft.volume%253D340%26rft.issue%253D9%26rft.spage%253D685%26rft.epage%253D691%26rft.atitle%253DA%2BControlled%2BTrial%2Bof%2BSustained-Release%2BBupropion%252C%2Ba%2BNicotine%2BPatch%252C%2Bor%2BBoth%2Bfor%2BSmoking%2BCessation%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJM199903043400903%26rft_id%253Dinfo%253Apmid%252F10053177%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1056/NEJM199903043400903&link_type=DOI [5]: /lookup/external-ref?access_num=10053177&link_type=MED&atom=%2Fbmj%2F322%2F7283%2F431.atom [6]: /lookup/external-ref?access_num=000078955200003&link_type=ISI